CephalalgiaPub Date : 2025-01-01DOI: 10.1177/03331024241308154
Dwij Mehta, Sanjay Cheema, Sophie Glover, Ayman M Qureshi, Indran Davagnanam, Salwa Kamourieh, Parag Sayal, Ahmed Toma, Susie Lagrata, Clare Joy, Callum Duncan, Jane Anderson, Brendan Davies, Paul J Dorman, Heather Angus-Leppan, James Walkden, Jonathan Rohrer, Manjit S Matharu
{"title":"Defining the typical characteristics of orthostatic headache in patients with spontaneous intracranial hypotension.","authors":"Dwij Mehta, Sanjay Cheema, Sophie Glover, Ayman M Qureshi, Indran Davagnanam, Salwa Kamourieh, Parag Sayal, Ahmed Toma, Susie Lagrata, Clare Joy, Callum Duncan, Jane Anderson, Brendan Davies, Paul J Dorman, Heather Angus-Leppan, James Walkden, Jonathan Rohrer, Manjit S Matharu","doi":"10.1177/03331024241308154","DOIUrl":"https://doi.org/10.1177/03331024241308154","url":null,"abstract":"<p><strong>Background: </strong>Orthostatic headache (OH) is a common feature of various conditions, including spontaneous intracranial hypotension (SIH), but no precise definition currently exists outlining the typical OH characteristics. This ambiguity risks misdiagnosis with unnecessary investigations and delay in institution of treatment. The present study aimed to carry out structured phenotyping of OH in patients with SIH with the aim of outlining its typical characteristics.</p><p><strong>Methods: </strong>Eligible patients with clinico-radiological confirmed SIH underwent a structured interview, after which a specialist interest group utilised the modified Delphi process to analyse the data and achieve consensus on defining the typical characteristics of OH in SIH.</p><p><strong>Results: </strong>In total, 137 patients were recruited. OH was present in 75.9%. Typical OH characteristics in SIH were defined as having a baseline severity (lying flat) on waking up of ≤3 (0-10, verbal response scale), headache onset-time of ≤4.5 h on becoming upright, time to peak severity of ≤7.5 h and an offset to baseline severity within 1.5 h of recumbency. Intra-individual consistency in the onset and offset-time was deemed a necessary characteristic.</p><p><strong>Conclusions: </strong>Defining typical OH characteristics has the potential of enhancing SIH diagnostics and management, at the same time as minimising unwarranted invasive procedures.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 1","pages":"3331024241308154"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CephalalgiaPub Date : 2025-01-01DOI: 10.1177/03331024241297673
Britt W H van der Arend, Floor C van Welie, Michael H Olsen, Jan Versijpt, Antoinette Maassen Van Den Brink, Gisela M Terwindt
{"title":"Impact of CGRP monoclonal antibody treatment on blood pressure in patients with migraine: A systematic review and potential clinical implications.","authors":"Britt W H van der Arend, Floor C van Welie, Michael H Olsen, Jan Versijpt, Antoinette Maassen Van Den Brink, Gisela M Terwindt","doi":"10.1177/03331024241297673","DOIUrl":"https://doi.org/10.1177/03331024241297673","url":null,"abstract":"<p><strong>Background: </strong>Monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) or the CGRP-receptor have revolutionized the prevention of migraine. Despite their effectiveness, worries have surfaced regarding potential unwanted cardiovascular effects linked to the vasodilation function of CGRP, suggesting a potential influence on blood pressure (BP).</p><p><strong>Methods: </strong>Studies were systematically retrieved from PubMed, Cochrane Database of Systematic Reviews, Web of Science, MEDLINE and EMBASE up to 1 May 2024. We focused on randomized controlled trials and observational cohort or case-control studies examining the impact of anti-CGRP(R)-monoclonal antibodies (mAbs) compared to control treatments on BP in patients with migraine. Two reviewers independently conducted study selection, data extraction and risk of bias assessment.</p><p><strong>Results: </strong>The literature search yielded 693 articles. After removing duplicates and conducting screening, 22 full-text articles were evaluated, with only four studies meeting the inclusion criteria. Among these, only one study had a low risk of bias and reported elevated BP following initiation of anti-CGRP(R)-mAb treatment.</p><p><strong>Conclusions: </strong>Although anti-CGRP(R)-mAbs offer substantial benefits for migraine prevention, the potential risk of increased BP requires attention. Despite the current limited evidence, clinicians are urged to monitor BP of migraine patients undergoing treatment with anti-CGRP(R)-mAbs and to remain aware of the increased risk of cardiovascular events in these patients.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 1","pages":"3331024241297673"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Migraine and its major subtypes - with and without aura are associated with polygenic scores for autism.","authors":"Salahuddin Mohammad, Giorgia Bussu, Gull Rukh, Helgi B Schiöth, Jessica Mwinyi","doi":"10.1177/03331024241312666","DOIUrl":"https://doi.org/10.1177/03331024241312666","url":null,"abstract":"<p><strong>Background: </strong>Individuals with autism spectrum disorder (ASD) experience a wide array of neurological, psychiatric and medical comorbidities, yet little attention has been given to the potential link between ASD and migraine, one of the most prevalent neurological disorders worldwide. This study aimed to investigate whether a genetic predisposition for ASD is linked to migraine and its major subtypes, with and without aura. Additionally, potential moderator and mediators of the association between ASD and migraine were explored.</p><p><strong>Methods: </strong>Polygenic scores (PGS) for ASD were constructed based on the genome-wide association study by the Psychiatric Genomics Consortium, on the UK Biobank cohort dataset comprising 337,386 participants using PRSice-2. Regression analyses were performed to investigate the association of ASD PGS with migraine and its major subtypes, with and without aura. Sex was explored as a potential moderating factor. The mediation analyses took into consideration variables such as education, personality trait neuroticism, body mass index (BMI) and four categories of comorbidities (psychiatric, vascular, neurologic and others).</p><p><strong>Results: </strong>ASD PGS were significantly and positively associated with migraine (odds ratio (OR) = 1.04, 95% confidence interval (CI) = 1.02-1.05, <i>p </i>< 0.002), migraine without aura (OR = 1.05, 95% CI = 1.02-1.07, <i>p </i>< 0.002) and migraine with aura (OR = 1.05, 95% CI = 1.02-1.07, <i>p </i>< 0.002). No moderating effect of sex on the association between ASD PGS and migraine was observed. As for potential mediators, only the personality trait neuroticism significantly mediated the association between ASD PGS and migraine, with the proportion of effect mediated 8.75% (95% CI = 4-18%).</p><p><strong>Conclusions: </strong>Our study suggests that individuals genetically predisposed to autism are at higher risk of experiencing migraine, including the two major subtypes, with and without aura. While emphasizing the complex shared genetic and pathophysiological interactions of these conditions, the role of personality trait neuroticism as a mediator of this relationship is highlighted.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 1","pages":"3331024241312666"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CephalalgiaPub Date : 2025-01-01DOI: 10.1177/03331024241306103
Christian Staehr, Mette Nyegaard, Flemming W Bach, Palle Duun Rohde, Vladimir V Matchkov
{"title":"Exploring the association between familial hemiplegic migraine genes (<i>CACNA1A</i>, <i>ATP1A2</i> and <i>SCN1A</i>) with migraine and epilepsy: A UK Biobank exome-wide association study.","authors":"Christian Staehr, Mette Nyegaard, Flemming W Bach, Palle Duun Rohde, Vladimir V Matchkov","doi":"10.1177/03331024241306103","DOIUrl":"https://doi.org/10.1177/03331024241306103","url":null,"abstract":"<p><strong>Background: </strong>Familial hemiplegic migraine (FHM) types 1-3 are associated with protein-altering genetic variants in <i>CACNA1A</i>, <i>ATP1A2</i> and <i>SCN1A</i>, respectively. These genes have also been linked to epilepsy. Previous studies primarily focused on phenotypes, examining genetic variants in individuals with characteristic FHM symptoms. This study aimed to investigate the association of FHM genetic variation with migraine and epilepsy, utilizing a genotype-first approach.</p><p><strong>Methods: </strong>Whole-exome sequence data from 454,706 individuals from the UK Biobank were examined for self-reported and inpatient-diagnosed migraine and epilepsy. Carriers were compared with non-carriers in a burden analysis using logistic regression while accounting for age, biological sex and UK Biobank assessment center. A machine learning-based approach was employed to predict whether variants resulted in gain-of-function (GoF), loss-of-function (LoF) or neutral effects.</p><p><strong>Results: </strong>Heterozygous carriers of GoF <i>CACNA1A</i> variants, LoF <i>ATP1A2</i> variants or neutral <i>SCN1A</i> variants were at increased risk of migraine. Homozygous carriers of neutral <i>SCN1A</i> variants were also associated with migraine but these carriers showed a reduced disease risk of epilepsy.</p><p><strong>Conclusions: </strong>Heterozygous genotypes in all three FHM genes were associated with migraine but not epilepsy in this genotype-focused study. Homozygous <i>SCN1A</i> genotypes also showed increased disease risk of migraine, yet these carriers were protected against epilepsy.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 1","pages":"3331024241306103"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CephalalgiaPub Date : 2025-01-01DOI: 10.1177/03331024241310550
Manvir Kaur, Nicholas A Ward, Kelly L Karlage, Catherine W Morgans, Sue A Aicher, Tally M Largent-Milnes
{"title":"Sex differences in photophobic behaviors following cortical spreading depression in rats.","authors":"Manvir Kaur, Nicholas A Ward, Kelly L Karlage, Catherine W Morgans, Sue A Aicher, Tally M Largent-Milnes","doi":"10.1177/03331024241310550","DOIUrl":"https://doi.org/10.1177/03331024241310550","url":null,"abstract":"<p><strong>Purpose: </strong>Photophobia is a common and debilitating symptom associated with migraine. Women are disproportionately affected by migraines, with a higher prevalence and more severe symptoms compared to men. This study investigated the effects of cortical spreading depression on light-aversive and dark-seeking behaviors in a rat model, with an emphasis on sex differences.</p><p><strong>Method: </strong>Experiments were conducted on seven to eight-week-old male and female Sprague Dawley rats. cortical spreading depression was modeled by injections of potassium chloride or artificial cerebrospinal fluid into the occipital cortex through a guide cannula. Key behavioral assessments included light-aversive and dark-seeking behaviors measured using a three-chamber box, pupil to iris ratio, periorbital tightening, periorbital allodynia and facial withdrawal thresholds.</p><p><strong>Results: </strong>Our results demonstrated that cortical potassium chloride injections significantly increased photophobic behaviors, particularly in female rats. Specifically, potassium chloride-injected females demonstrated a significant reduction in the time spent in the light chamber (p = 0.001) and increased time in the dark chamber compared to control rats (p = 0.01), indicating heightened light-aversion. Females exhibited more substantial pupil constriction and eyelid closure at 180 min after potassium chloride injection compared to artificial cerebrospinal fluid injection, suggesting a stronger physiological response to light. Similarly, a greater percent of female rats displayed periorbital allodynia (withdrawal threshold <6 g) over a post injection time course compared to male rats. Among rats that exhibited periorbital allodynia at least two consecutive time points, females had significantly lower facial withdrawal thresholds than males at 60-, 90-, 120-, and 180-min post injection (p < 0.05), suggesting a difference in magnitude and duration. Furthermore, the area under the curve for the time course experiment indicated development of tactile allodynia in periorbital region among female rats (p < 0.0001).</p><p><strong>Conclusion: </strong>Altogether these findings highlight the importance of considering sex-specific differences in developing therapeutic strategies for the treatment of migraine. We report for the first time a complete time course analysis of migraine-related responses, providing a comprehensive overview of the dynamics involved. The results suggest that potassium chloride-induced cortical spreading depression may offer a valuable model for studying the underlying mechanisms and sex differences of photophobia in migraine, aiding in the development of targeted treatments.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 1","pages":"3331024241310550"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CephalalgiaPub Date : 2025-01-01DOI: 10.1177/03331024241312612
Pacôme Constant Dit Beaufils, Syrine Ben Mammou, Benoît Guillon, Solène de Gaalon
{"title":"Drug-induced reversible cerebral vasoconstriction syndrome: Lessons from the real world.","authors":"Pacôme Constant Dit Beaufils, Syrine Ben Mammou, Benoît Guillon, Solène de Gaalon","doi":"10.1177/03331024241312612","DOIUrl":"https://doi.org/10.1177/03331024241312612","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 1","pages":"3331024241312612"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CephalalgiaPub Date : 2025-01-01DOI: 10.1177/03331024241313378
Grace J Lee, Veronica Hode, Teodora Georgieva, Jill Rau, David W Dodick, Todd J Schwedt, Volker Neugebauer, Frank Porreca, Edita Navratilova
{"title":"Prolactin-induced sensitization of trigeminal nociceptors promotes migraine co-morbidity in endometriosis.","authors":"Grace J Lee, Veronica Hode, Teodora Georgieva, Jill Rau, David W Dodick, Todd J Schwedt, Volker Neugebauer, Frank Porreca, Edita Navratilova","doi":"10.1177/03331024241313378","DOIUrl":"https://doi.org/10.1177/03331024241313378","url":null,"abstract":"<p><strong>Background: </strong>Women with endometriosis are more likely to have migraine. The mechanisms underlying this co-morbidity are unknown. Prolactin, a neurohormone secreted and released into circulation from the anterior pituitary, can sensitize sensory neurons from female, but not male, rodents, monkeys and human donors.</p><p><strong>Methods: </strong>We used a syngeneic model of endometriosis to determine whether elevated prolactin levels can sensitize trigeminal ganglion neurons and increase vulnerability to migraine pain.</p><p><strong>Results: </strong>Mice with endometriotic lesions showed increased serum prolactin levels and developed persistent abdominal, but not cephalic, allodynia. However, inhalation of a transient receptor potential ankyrin 1 agonist, umbellulone, a known environmental trigger of headache in some patients, elicited cephalic allodynia in mice with endometriosis but not sham controls, suggesting that endometriosis can promote sensitization of trigeminal neurons and migraine attacks. Endometriosis dysregulated the expression of prolactin receptor isoforms in trigeminal neurons and increased their excitability measured by <i>in vitro</i> patch clamp electrophysiology. Inhibition of pituitary prolactin following a 2-week treatment with a dopamine receptor agonist, cabergoline, prevented cephalic allodynia elicited by activation of trigeminal afferents with umbellulone. Cabergoline treatment also normalized the expression of prolactin receptor isoforms in trigeminal ganglia and the hyperexcitability of trigeminal neurons.</p><p><strong>Conclusions: </strong>These data demonstrate that circulating prolactin in endometriosis promotes vulnerability to migraine through sensitization of trigeminal afferents. Clinically available dopamine receptor agonists or novel monoclonal antibodies targeting prolactin signaling may be effective for migraine prevention in women with endometriosis.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 1","pages":"3331024241313378"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CephalalgiaPub Date : 2025-01-01DOI: 10.1177/03331024241310519
Nina Riggins, Faraidoon Haghdoost
{"title":"Building community and visibility: A year of social media growth for Cephalalgia.","authors":"Nina Riggins, Faraidoon Haghdoost","doi":"10.1177/03331024241310519","DOIUrl":"https://doi.org/10.1177/03331024241310519","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 1","pages":"3331024241310519"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CephalalgiaPub Date : 2024-12-01DOI: 10.1177/03331024241300883
Cédric Gollion, David Garcia-Azorin
{"title":"Communicate your findings with graphical abstract in <i>Cephalalgia</i> : Why and how?","authors":"Cédric Gollion, David Garcia-Azorin","doi":"10.1177/03331024241300883","DOIUrl":"https://doi.org/10.1177/03331024241300883","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"44 12","pages":"3331024241300883"},"PeriodicalIF":5.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}